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Sue Woolfenden, MBBS, MPH, FRACP; David Dossetor, FRCP, FRCPsych, MD; Katrina Williams, MBBS, MSc, FRACP, FAFPHM

Arch Pediatr Adolesc Med. 2002;156:345-348.

Objective  To describe the presentations, characteristics, and follow-up care of children and adolescents aged 10 to 18 years who present to emergency departments (EDs) with acute alcohol intoxication/self-poisoning.

Design  Retrospective medical record review.

Setting  Five EDs in Western Sydney, Australia.

Participants  Patients aged 10 to 18 years who presented to EDs with acute alcohol intoxication/self-poisoning between January 1, 1996, and December 31, 2000.

Main Outcome Measures  Frequency of presentations; presentation characteristics; psychosocial characteristics; and presence or absence of follow-up.

Results  Two hundred twelve children and adolescents presented to EDs 216 times. Of the 212 patients, 49 (23%) were 14 years or younger, and the youngest was aged 10 years. The majority (82%) came after hours and were brought in by emergency services (77%). In 13% of presentations, verbal and/or physical aggression was present, and a threat of self-harm was present in 2% of cases. A mental health worker was consulted about the child or adolescent in only 6% of presentations. Most children and adolescents (85%) were discharged from the ED. Of concern, in 56% of presentations, a follow-up plan was not recorded. There was documentation of mental health follow-up in only 14% of presentations and follow-up from drug and alcohol services in only 1%. Forensic history, school functioning, and a history of past mental health problems were not documented in more than 60% of the medical records examined.

Conclusions  When children or adolescents present to an ED with acute alcohol intoxication/self-poisoning, their risk factors for psychosocial dysfunction appear to be inadequately assessed, documented, and followed up. Clear guidelines for assessment and referral pathways must be established in EDs.

From the Centre for the Prevention of Psychological Problems in Children (Dr Woolfenden) and the Departments of Psychological Medicine (Drs Woolfenden and Dossetor) and Paediatrics and Child Health (Dr Williams), Children's Hospital at Westmead, University of Sydney, Sydney, Australia.

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